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Religion and Health Project Evaluation Data Analysis and Final Library IJRC lntersat~onalWatet and Sanitation Centre Tel.: +31 70 30 689 80 Fax: +31 70 35 899 ~ Religion and Health Project Evaluation Data Analysis and Final Report Anims at the Kuenga Rabten Anim Dratshang Dratshang Lhentshog Health Division UNICEF (Prepared by: MarionYoung - July 1999) 824BT—16994 LIBRARY IRC P0 Box 93190, 2509 AD THE HAGUE Tel.: +31 70 30 689 80 Fax: +31 703589964 BARCODE: 16559 RHP Evaluation Report - Inlroductioii Religion and Health Project Evaluation Data Analysis and Final Report Anims at the Kuenga Rabten Anim Dratshang Dratshang Lhentshog Health Division UNICEF (Prçpared by: Marion Young - July 1999) I. 1 RHP Report 1 Introduction RHP Evaluation Report - Introduction RI-IP Report I Introduction RHP Evaluation Report - Introduction Menchey Rimdu Medicine and Puja Some years ago a young Bhutanese boy fell sick. He couldn’t walk, he couldn’t feel anything in his hands and feet and he didn’t want to eat anything. His mother called the health worker who came from the BHU four hours away to see the boy. The health worker left ~onie medicine for the boy to take but every time he was given the medicine it made him vomit. His mother called the local religious practitioner who told the boy’.s mother that an evil spirit lived in the tree outside the house. They must cut down the tree and plant another tree in its place. Only then would the boy be ‘able to take the medicine. This was done the tree was cut down, another tree was planted and the boy was able to take the medicine. Happily for the whole family. the boy recovered. The boy is now a monk and has recently attended Religion and Health Project training. He and his family believe that both puja and medicine work together. A personal story told by a rponk in Bhutan June 1999 RHP Report I Introduction RHP Evaluation Report - Introduction Table of Contents INTRODUCTION 7 RUP PROJECT OBJECTIVES 8 RHP EVALUATION OBJECTIVES 9 EVALUATION REPORT AND EVALUATION ANALYSIS 9 BACKGROUND TO THE RHP PROJECT 10 EVALUATION METHODOLOGY 12 EVAIJJATION TooLs 12 EvAI.tJArloN PROCESS 13 EVALUATION LIMITATIONS 20 KEY QUESTIONS 23 KEY QUESTION a I. - ROLE OF RELiGIOUS COMMUNITIES IN PROMOTING HEAL TH 25 Is f/ic health pronlotion role of ~ religious coiiiiiiun hi (ordained monks) acid/or coininunitv—based reli~ç’iouspractitioners understood by //ieniselves (acid hi’ the coinnuueinlj’ and by health workers)? 25 CONCLUSIONS 26 KEY QUESTION a2. - ROLE OF RELIGIOUS COMMuNITIES IN PROMOTING HEALTH 27 Hon successful have the religious community cind/or conumuni y—hasedreligious practitioners been in their role as heal//i promoters (v/en’s of religious communities themselves, co,nmunhtv nieinbers and health ti’orkers to he asked,I? 27 CONCI,IJSIONS 28 KEY QUESTION a3. - ROLE OF RELIGIOUS COMMUNITIES IN PROMOTING HEALTH 29 DC) ihe religious comifluflity cind/or coniniuniti’—hcised religious prcuciitioner,s kel 1/ia! 1/icy can contribute i/lore in pro/noting health? lives. u/cat more and lion’? 29 CONClUSIONS 30 KEY QUESTION a4. - ROLE OF RELIGIOUS COMMUNiTIES IN PROMOTING HE/IL TII 31 Do coinnn,nm’-hased religious practitioners (such as tsips. pawos, pamos, gomchens, /akris) view the role heiny promoted by the RI-/P as ci i/flea! to their livelihood? (above cited people are usually a~iproachec/in times of ill health to pertorni rituals/pu/as and get paid in cash or kind for their services) 31 CON:I.lJsIoNs I KEY QUESTION bI. BEHAVIOURAL CHANGES IN THE RELIGIOUS COMMUNITY 32 /1re thc’re c/ianges in the heal//i seeking acid hi‘glene practices of the religious comninlinity and/or coinnuinit v—basedreligious pracii/loners (i/Icr RI—/P irai/flhig workshops.’ 32 C0NI.vsIoNs 33 KEY QUESTION b2. - BEHAVIOURAL CHANGES IN THE RELIGIOUS COMML/NIT}’ 34 flout’ /iave 1/ic iniproveci uc’aicr/sanita/ion/acilities been used aiid niaiilainecl.’ 34 CONClUSIONS 3S KEY QUESTION b3. - BE/IA VIOURAL CHANGES IN THE RELIGIOUS COMMUNITY 36 I—/ate I/ic’ religious conc/lulnitys a,!ituck’s toii’arc/s sanitation and hygiene changed ni/li the introduction of i/n/iroVecl n’atec~sa;ii/ationfacilities.’ 36 CONCI,IJSIONS 36 KEY QUESTION b4. - BEHA VIOURAL ChANGES IN TIlE RELiGIOUS COMMUIVIT 37 RI-IP Report I Introduction 4 RHP Evaluation Report - Introduction Do the religious conimnunity cucici/or comm unity—basedreligious practitioners provide advice on health care when approached fbr religious services in the event offamily illness? 37 CONCLUSIONS 37 KEY QUESTION ci. - BEHAVIOURAL CHANGES IN THE COMMUNITY 38 Do c’omnmnuni/ members receive health advice from the religious communitV and/or community-based religious practitioners when approached/or religious services in the event offancily illness? 38 CONCLUSIONS 38 KEY QUESTION c2. - BEHA VIOURAL CHANGES IN THE COMMUNITY 40 Has the religious conunu unity and/or theconinu unity—based religious practitioners influenced the health seeking amid hygiene practices of the community? 40 CONCLUSIONS 40 KEY QUESTION c3. - BEHA VIOURAL CHANGES IN THE COMMUNITY 42 Are there any ac/c/edac/vantages oft/ic religious’ conumnunity acid/or conununity—hased religious prcuc’titionem~s’pro/noting /cecm It/i? 42 CONCIIJSIONS 42 KEY QUESTION c4. - BEHA VIOURAL CHANGES IN THE COMMUNITY 43 Are the,’e c/ianges in the heal/li seeking and hygiene practices o/the religious conimunity and/or conunuinity—liased religious practitioners after RHP training ii’orkshops? 43 CONCI.IJSIONS 44 KEY QUESTIONd1.-HEALTH WORKERS’ VIEWS 45 Rate 1/ic effectiveness (?f the religious conununity and conumziniiv—based religious practitioners as promoters 0/health nuessages 45 CONClUSIONS 45 KEY QUESTION d2. - hEALTH WORKERS’ VIEWS 46 Do /ueciltli 1 ‘orkers view 1/ic religious conunu,ui/I’ and coinmnumnty—basec/ religious practitioners as competitors or conuplenmentcirv:’ 47 Conclusions 47 KEY QUESTION d3. - HEALTH WORKERS’ VIEWS 48 I-las there been an increased number of pcmtientsfi’onu f/ic conunu/uty referred by the religious’ community cinch/or community—based religious practitioners f/illon’ing RI—/P n’orks/iops? 48 CoNcLusIoNs 48 KEY QUESTION el/ e2. - EFFECTIVENESS OF TRAINING WORKSHOPS 49 JVluit knoi’ledge /uci.s’ /een retained by religious p~~on.s’who attended RI-/P training ui’orksliops? 49 R/icut is the know/cc/ge of religious persons lu’/io have not heemi trained? 49 CONCUISIONS 50 KEY QUESTION e3. - EFFECT! VENESS OF TRAINING WORKSHOPS 52 I Chat acldutionc,l areas of lieu/tb n’oulcl the reli~giou.sconnmmunitv d,nd/./or comnmnumnity—basec/religious /1/ductitioners like to Iccurn cibouit in the training workshop to enhance their role as health promnoter.s’? 52 CONClUSIONS 53 KEY QUESTION e4. - EFFECTIVENESS OF TRAiNING WORKSHOPS 54 How cciii tmaining workshops befuirther immupm-ovecl.’ 54 CONCLUSIONS 54 KEY ISSUE - EFFECTIVENESS OF PROJECT MANAGEMENT 55 Hon ccnu RH!’ pro/ect nucunagecuuent be further improved? 55 CoN~.ItJsIoNs 55 KEY ISSUE — STD/AIDS 57 Issues relating to ~S’TD//I/DSknowledge among religious prcic’titioners 57 CONCI.USIONS 58 RHP Report I Introduction RHP Evaluation Report - Introduction MAIN CONCLUSIONS 59 COMPARATIVE ADVANTAGE OF RELIGIoUs PRAC’FITIONERS AS HEALI’H PROMOTERS 62 RECOMMENDATIONS 62 FUTURE STRATEGIES AND ACTIVITIES: SUGGESTIONS FOR PROJECT IMPROVEMENT 63 STRATEGY I: PROJECT MANAGEMENF ANI) PAR’I’NERSIILP 63 POSI’-EVALUATION REVIEW OFTI-IE RI-IP PROJECT 13Y SI’AKEIIOI.DERS 63 ACTIVItY I: REVIEW PROJECI’ OBJEC’I’IVES 63 ACTIVITY 2: REVIEW ROLES AND RESPONSIIIII..ITIFS 64 ACTIVITY 3: DEFINE PRIORITY TARGET GROUPS 65 AcTIVITY 4: DRAW ISP A PLAN OF ACTION 65 ACTIVITY 5: REVIEW OPPORTUNITIES FOR CiREATER DIX’EN’I’RAI..ISAFION 65 ACTIVIlY 6: FACILITATE A NFL-WORK BETWEEN COMMUNICATORS OF H+I-I MESSAGES 66 STRA’IEGY 2. MoNITORING ANI) EVALUATION 67 INTRODUCE A MONI’I’ORING ANI) EVAluATION PROCEss 67 ACTIVITY 7: BASEE.LNE DATA COLLECILON 67 ACTIVITY 8: Tool_s FOR ON—GOING MONIIORINCi OF SoFTWARE ANI) HARD WARE.....,.................................. 67 ActIvITY 9: USE OF WORKSF 101’ REPORTS 68 ACL’IvL’I’Y 10: ROLES AND RESPONSIBIlITIES FOR MONIlORING & EVALUATION 68 ACtIVItY II: PLANNING FOR EVALUATION 68 SLRA’IEGY 3. TRAINING 71 RFVll~\vDIE PRESENT TRAINING PROGRAMMES ANI) MODIFY AS NECESSARY ...,.........,.....,,.....,.,.,..,.,,.,.,,.,,.,,. 7I AcIIvvI’Y 2: IDFNTIFICATION 01 AR(iCI GROUPS ANI) PRIORITIES .,,,.,,..,,,,.,.,.,,,,,,.,,.,,,.,.,,,,.,,..,,.,,,,,.,.,,,.,,,., 72 ACTIVFFY 13: NEEDs ANAlYsIS 72 ACI1VIIY 14: WORKSIIOP PI_ANNING 72 ACtIVITY IS: REVLE~vRHP TRAINING - ALTERNATIVE MODELS 73 SUMMARY OF FUTURE STRATEGIES AND GUIDELINE OF ACTIVITIES 74 PR0JI.cr MANAGEMENI AND PAR IN! RSI LIP 74 MONItORING AND EVALUATION 74 TRAINING 74 EXAMPI.! I: SIAKEIIOI,DER l’ARrIcIpAFION ANAlYSIS MAtRIX — .WII() I)OIS WIIAT’ 75 ExAML’IE 2: SWOC ANALYSIS (SIRENOTI IS, WEAKNESSES, OPI’oitIIJNlIIFs. CONSTRAINTS)..........,.....,...... 76 EXAMI’IE 3: AC’I’IVIrII~sANI) ACTION — WIIO/WIIEN 77 EXAMPLE 4: M0NIIORING FItAM[;woltk FOR RH!’ WORKSIIOPS 78 (;LOSSARY 79 RI-IP Report 1 Introduction 6 RHP Evaluation Report - Introduction Introduction The Religion and Health Project was initiated in 1992 forming a partnership between the Central Monastic Body. Dratsang Lhentsog and Health Division with financial support from UNICEF. The project has two basic components: a) Training of religious communities in basic health information in order for them to become good role models and effective health promoters b) Improvement of water sanitation and kitchen facilities of monastic institutions. In preparation for the joint RGoB and UNICEF mid-term review of the current country programme (1997-2001), an evaluation of the Religion and Health Project was undertaken from April to July 1999. Development of an evaluation protocol was contracted to Ms Caroline Marrs who presented the evaluation tools and methodology at a pre-evaluation workshop attended by all project stakeholders in May 1 999. Data collection, analysis and report preparation was contracted to Ms Marion Young. A translator, Sonam Dhendup.
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